Predictive value of exhaled nitric oxide and aerobic capacity for sepsis complications after liver transplantation

Our objective was to investigate the predictive value of fractional nitric oxide (NO) concentration in exhaled breath (FeNO) and aerobic capacity (peak VO₂) for postoperative sepsis in liver transplantation candidates. Patients were identified and charts of all consecutive patients were prospectively reviewed. Bacterial sepsis represented the commonest postoperative complications (30%), which was attributed to peritonitis, pneumonia, and catheter‐related infections. Preoperative FeNO and peak VO₂ values were lower in patients with postoperative sepsis. Patients with sepsis required higher needs for mechanical ventilation and ICU length of stay. Inverse correlation was found between logarithmically FeNO‐transformed data and systolic pulmonary artery pressure (r = ?0.348; P = 0.018). Multivariate analyses using bootstrap sampling method indicated that odds of sepsis were associated with lower values of peak exercise VO₂ [OR = 0.790 (0.592; 0.925)] and reduced log(FeNo) [OR = 0.027 (0.001; 0.451)], but not with higher MELD scores [OR = 1.141 (0.970; 1.486)]. By evaluating the cutoff for the ROC curves in each bootstrap resampling, median and 95% confidence interval were calculated for peak VO₂: 17 [16.2; 22] ml/kg/min and FeNO: 17.2 [13.0; 33.9] ppb. We conclude that low peak exercise VO₂ and reduced FeNO may help identify patients who are at risk to develop perioperative sepsis.     

针刺蝶腭神经节对正常青年人鼻腔通气功能影响的研究

目的探讨针刺蝶腭神经节对正常青年志愿者鼻腔通气功能的影响。方法将50例受试者随机分为针刺组与对照组,每组各25例。针刺组进行标准的针刺蝶腭神经节刺激,对照组进行假针刺刺激,分别在针刺前、针刺后30 min、2 h及24 h进行评估。评估指标为自报鼻腔通气的变化、鼻腔通气功能检查(鼻阻力与鼻声反射)、鼻腔呼出气一氧化氮。结果与对照组比较,针刺组有更高比例的受试者汇报鼻腔通气改善,鼻阻力下降,鼻腔容积增加,且针刺后24 h鼻腔呼出气一氧化氮水平较对照组明显下降。结论针刺蝶腭神经节能够有效改善鼻腔通气,且效果能够持续24 h。     

长期吸入低浓度一氧化氮在支气管肺发育不良治疗中的安全性研究

目的：探讨吸入一氧化氮(inhaled nitric oxide,iNO)治疗支气管肺发育不良的疗效及安全性。方法收集2012年1月至2013年12月在我院新生儿科收治的确诊支气管肺发育不良患儿65例,根据是否给予iNO治疗,将患儿分为iNO治疗组35例及对照组30例。动态观察iNO治疗前后两组患儿的心率、血压、给氧时间、辅助通气时间、住院时间、NO2浓度、高铁血红蛋白浓度及凝血功能的变化。结果 iNO治疗组与对照组患儿的吸氧时间[(37±9)d vs.(55±7)d],辅助通气时间[(29±7)d vs.(35±9)d]及住院时间[(45±9)d vs.(54±7)d]比较,差异均有统计学意义(P﹤0.05)。治疗过程中两组患儿的心率、血压、凝血功能无明显变化;iNO治疗组和对照组患儿脑室内出血(28例vs.25例),动脉导管未闭(19例vs.17例),坏死性小肠结肠炎(9例vs.5例)的发生率差异均无统计学意义(P﹥0.05);iNO 组患儿早产儿视网膜病变的发生率(21例 vs.25例)差异有统计学意义(P﹤0.05)。结论长期iNO可以缩短吸氧时间、辅助通气时间,对心血管和凝血功能无明显不良反应,不增加颅内出血、早产儿视网膜病变等的发生。     

支气管哮喘患儿血清25-羟维生素D3水平及其与肺功能、呼出气一氧化氮的关系

目的：了解支气管哮喘（简称哮喘）患儿血清25-羟维生素D3[25（OH）D3]水平及其与肺功能、呼出气一氧化氮（ FeNO）的关系,为哮喘的治疗提供新的策略。方法选取门诊6~14岁初诊哮喘患儿112例为观察组,选取同期在儿童保健科体检的6~14岁健康儿童78例为对照组,通过电化学发光法检测两组患儿血清中25（ OH）D3的含量,检测哮喘患儿呼气峰流速（ PEF）、第1秒用力呼气容积（ FEV1）、呼气峰流速占预计值百分比（ PEF％ pred ）、第1秒用力呼气容积占预计值百分比（ FEV1％ pred）,对观察组患儿进行FeNO检测。对25（ OH）D3与PEF％ pred、FEV1％ pred、FeNO的相关性进行分析。结果观察组的维生素 D 缺乏、不足比例均高于对照组（χ2＝7.78,P ﹤0.01）;PEF％ pred、FEV1％ pred的值随血清25（OH）D3水平的下降而降低（F＝28.12、29.56,P均﹤0.05）, FeNO值随血清25（OH）D3水平的下降反而升高（F＝15.65,P﹤0.05）。结论维生素D缺乏或不足与儿童哮喘相关,与哮喘患儿肺功能下降有关,且可增加哮喘患儿气道炎症水平。     

Factors associated with breast milk intake among 9–10‐month‐old Malawian infants

Exclusive breastfeeding is recommended during the first 6 months of life; thereafter, continued breastfeeding along with nutritious complementary foods is recommended. Continued breastfeeding contributes a substantial proportion of nutrient needs and promotes healthy growth and development, but the quantity of breast milk consumed may be highly variable and little is known about the factors associated with breast milk intake after 6 months of age. The present study was conducted to assess factors associated with breast milk intake of Malawian infants at 9–10 months of age. Breast milk intake was measured using the dose‐to‐mother deuterium oxide dilution method in a subsample of 358 Malawian infants who were participating in a randomized controlled trial of lipid‐based nutrient supplements. Regression analysis was used to assess associations between breast milk intake and several maternal and infant variables. Mean (standard deviation) breast milk intake was 752 (244) g day^–1. In multiple regression, breast milk intake was positively associated with infant weight (+62 g per kg body weight, P < 0.01) and maternal height (P < 0.01) and negatively associated with maternal education and age (P < 0.01). There was a non‐significant (P = 0.063) inverse association between energy from non‐breast milk sources and breast milk intake. In this rural Malawian population, infant weight is the main predictor of breast milk intake, even after the first 6 months of life.     

Efficacy of zinc oxide nanoparticles in attenuating pancreatic damage in a rat model of streptozotocin-induced diabetes

Zinc oxide nanoparticles (ZnO NPs) therapy is a promising strategy for treatment of several diseases. We aimed to investigate the therapeutic potential of ZnO NPs in ameliorating the histopathological and functional alterations in the pancreas of a rat model of streptozotocin-induced diabetes. Rats were randomized into control, diabetic and ZnO NPs-treated diabetic groups. Biochemical assays of blood glucose and serum insulin were performed. Pancreas specimens were processed for light and electron microscope examinations. ZnO NPs effectively reversed diabetes-induced pancreatic injury, as evidenced by the structural and ultrastructural improvement and confirmed by biochemical normalization of blood glucose and serum insulin.     

The Effect of Sleep Deprivation on Cardiac Function and Tolerance to Ischemia-Reperfusion Injury in Male Rats

Background

Sleep deprivation (SD) is strongly associated with elevated risk for cardiovascular disease.

Objective

To determine the effect of SD on basal hemodynamic functions and tolerance to myocardial ischemia-reperfusion (IR) injury in male rats.

Method

SD was induced by using the flowerpot method for 4 days. Isolated hearts were perfused with Langendorff setup, and the following parameters were measured at baseline and after IR: left ventricular developed pressure (LVDP); heart rate (HR); and the maximum rate of increase and decrease of left ventricular pressure (±dp/dt). Heart NOx level, infarct size and coronary flow CK-MB and LDH were measured after IR. Systolic blood pressure (SBP) was measured at start and end of study.

Results

In the SD group, the baseline levels of LVDP (19%), +dp/dt (18%), and -dp/dt (21%) were significantly (p < 0.05) lower, and HR (32%) was significantly higher compared to the controls. After ischemia, hearts from SD group displayed a significant increase in HR together with a low hemodynamic function recovery compared to the controls. In the SD group, NOx level in heart, coronary flow CK-MB and LDH and infarct size significantly increased after IR; also SD rats had higher SBP after 4 days.

Conclusion

Hearts from SD rats had lower basal cardiac function and less tolerance to IR injury, which may be linked to an increase in NO production following IR.     

雪莲通脉丸对冠心病气虚血瘀证小鼠血管内皮细胞功能相关指标ET-1、NO、ACE的影响

目的 观察雪莲通脉丸对冠心病气虚血瘀证小鼠内皮素-1(ET-1)、一氧化氮(NO)和血管紧张素转换酶(ACE)的调节作用. 方法 建立冠心病气虚血瘀证小鼠模型,随机分为空白对照组、模型对照组、地奥心血康组和雪莲通脉丸组. 给药4周后取小鼠血清,ELISA试剂盒测定ET-1、NO和ACE浓度. 结果 与模型组比较,雪莲通脉丸组NO浓度显著升高,差异具有统计学意义(P<0.01);ET-1浓度降低,差异具有统计学意义(P<0.05);ACE浓度显著降低,差异具有统计学意义(P<0.01). 与地奥心血康组比较,雪莲通脉丸组NO浓度显著升高,ACE浓度显著降低,差异具有统计学意义(P<0.01). 结论 冠心病气虚血瘀证的发生可能与血管内皮细胞的功能指标具有相关性. 其中,冠心病气虚血瘀证可能与血清ET-1、ACE浓度呈正相关、与血清NO浓度呈负相关. 雪莲通脉丸对冠心病气虚血瘀证小鼠血管内皮细胞的功能指标具有调节作用,其机制可能与升高血清NO浓度、降低ET-1、ACE浓度有关,且与地奥心血康组比较在改善血清NO、ACE方面具有一定优势.     

热习服对大鼠血液代谢产物影响的研究

目的 探讨大鼠经热习服及后续热环境运动刺激后血浆中代谢产物的变化特征,筛选热习服特异性的指示标志物.方法 将16只SD大鼠随机分为热习服组和对照组(n=8),热习服组大鼠经每日2h热习服训练,对照组大鼠不做相应处理,连续14d,结束后次日采集两组大鼠眼眶血.休息4d后所有大鼠均经热环境运动刺激30 min,麻醉后取腹主动脉血并离心取血浆.使用Bruker 600 MHz核磁共振谱仪检测两组大鼠血浆中代谢产物的1 HNMR谱,分析热习服及热环境运动刺激后大鼠血浆代谢产物的变化.结果 与对照组相比,热习服组大鼠在热习服后血浆中不饱和脂肪酸、谷氨酸、脂质和二甲胺的含量升高,而葡萄糖、肌醇、牛磺酸、苏氨酸和三甲胺氧化物含量均下降(P＜0.05);而在热环境运动刺激后,热习服组大鼠血浆中三甲胺氧化物、谷氨酸和脂质的含量均下降(P＜0.05).结论 经热习服和热环境运动刺激后,大鼠血浆中代谢物质发生了明显变化.三甲胺氧化物有可能作为热习服的指示性标志物,为制定热习服客观评价体系提供有意义的线索.